﻿<!DOCTYPE html>
<html>
  <head>
    <title>转诊弹窗</title>
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    <script type="text/javascript">
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      $axure.utils.getOtherPath = function() { return 'resources/Other.html'; };
      $axure.utils.getReloadPath = function() { return 'resources/reload.html'; };
    </script>
  </head>
  <body>
    <div id="base" class="">

      <!-- Unnamed (矩形) -->
      <div id="u344" class="ax_default box_1">
        <div id="u344_div" class=""></div>
        <!-- Unnamed () -->
        <div id="u345" class="text" style="display:none; visibility: hidden">
          <p><span></span></p>
        </div>
      </div>

      <!-- Unnamed (矩形) -->
      <div id="u346" class="ax_default box_1">
        <div id="u346_div" class=""></div>
        <!-- Unnamed () -->
        <div id="u347" class="text" style="display:none; visibility: hidden">
          <p><span></span></p>
        </div>
      </div>

      <!-- Unnamed (矩形) -->
      <div id="u348" class="ax_default label">
        <div id="u348_div" class=""></div>
        <!-- Unnamed () -->
        <div id="u349" class="text">
          <p><span>转诊单</span></p>
        </div>
      </div>

      <!-- Unnamed (表格) -->
      <div id="u350" class="ax_default">

        <!-- Unnamed (单元格) -->
        <div id="u351" class="ax_default table_cell">
          <img id="u351_img" class="img " src="images/转诊弹窗/u351.png"/>
          <!-- Unnamed () -->
          <div id="u352" class="text">
            <p><span>姓名：</span></p>
          </div>
        </div>

        <!-- Unnamed (单元格) -->
        <div id="u353" class="ax_default table_cell">
          <img id="u353_img" class="img " src="images/转诊弹窗/u353.png"/>
          <!-- Unnamed () -->
          <div id="u354" class="text" style="display:none; visibility: hidden">
            <p><span></span></p>
          </div>
        </div>

        <!-- Unnamed (单元格) -->
        <div id="u355" class="ax_default table_cell">
          <img id="u355_img" class="img " src="images/转诊弹窗/u355.png"/>
          <!-- Unnamed () -->
          <div id="u356" class="text">
            <p><span>张三</span></p>
          </div>
        </div>

        <!-- Unnamed (单元格) -->
        <div id="u357" class="ax_default table_cell">
          <img id="u357_img" class="img " src="images/转诊弹窗/u351.png"/>
          <!-- Unnamed () -->
          <div id="u358" class="text">
            <p><span>身份证号码：</span></p>
          </div>
        </div>

        <!-- Unnamed (单元格) -->
        <div id="u359" class="ax_default table_cell">
          <img id="u359_img" class="img " src="images/转诊弹窗/u353.png"/>
          <!-- Unnamed () -->
          <div id="u360" class="text" style="display:none; visibility: hidden">
            <p><span></span></p>
          </div>
        </div>

        <!-- Unnamed (单元格) -->
        <div id="u361" class="ax_default table_cell">
          <img id="u361_img" class="img " src="images/转诊弹窗/u355.png"/>
          <!-- Unnamed () -->
          <div id="u362" class="text">
            <p><span>210503199300000000</span></p>
          </div>
        </div>

        <!-- Unnamed (单元格) -->
        <div id="u363" class="ax_default table_cell">
          <img id="u363_img" class="img " src="images/转诊弹窗/u351.png"/>
          <!-- Unnamed () -->
          <div id="u364" class="text">
            <p><span>医保卡号：</span></p>
          </div>
        </div>

        <!-- Unnamed (单元格) -->
        <div id="u365" class="ax_default table_cell">
          <img id="u365_img" class="img " src="images/转诊弹窗/u353.png"/>
          <!-- Unnamed () -->
          <div id="u366" class="text" style="display:none; visibility: hidden">
            <p><span></span></p>
          </div>
        </div>

        <!-- Unnamed (单元格) -->
        <div id="u367" class="ax_default table_cell">
          <img id="u367_img" class="img " src="images/转诊弹窗/u355.png"/>
          <!-- Unnamed () -->
          <div id="u368" class="text" style="display:none; visibility: hidden">
            <p><span></span></p>
          </div>
        </div>

        <!-- Unnamed (单元格) -->
        <div id="u369" class="ax_default table_cell">
          <img id="u369_img" class="img " src="images/转诊弹窗/u351.png"/>
          <!-- Unnamed () -->
          <div id="u370" class="text">
            <p><span>性别：</span></p>
          </div>
        </div>

        <!-- Unnamed (单元格) -->
        <div id="u371" class="ax_default table_cell">
          <img id="u371_img" class="img " src="images/转诊弹窗/u353.png"/>
          <!-- Unnamed () -->
          <div id="u372" class="text" style="display:none; visibility: hidden">
            <p><span></span></p>
          </div>
        </div>

        <!-- Unnamed (单元格) -->
        <div id="u373" class="ax_default table_cell">
          <img id="u373_img" class="img " src="images/转诊弹窗/u355.png"/>
          <!-- Unnamed () -->
          <div id="u374" class="text">
            <p><span>男</span></p>
          </div>
        </div>

        <!-- Unnamed (单元格) -->
        <div id="u375" class="ax_default table_cell">
          <img id="u375_img" class="img " src="images/转诊弹窗/u351.png"/>
          <!-- Unnamed () -->
          <div id="u376" class="text">
            <p><span>出生日期：</span></p>
          </div>
        </div>

        <!-- Unnamed (单元格) -->
        <div id="u377" class="ax_default table_cell">
          <img id="u377_img" class="img " src="images/转诊弹窗/u353.png"/>
          <!-- Unnamed () -->
          <div id="u378" class="text" style="display:none; visibility: hidden">
            <p><span></span></p>
          </div>
        </div>

        <!-- Unnamed (单元格) -->
        <div id="u379" class="ax_default table_cell">
          <img id="u379_img" class="img " src="images/转诊弹窗/u355.png"/>
          <!-- Unnamed () -->
          <div id="u380" class="text" style="display:none; visibility: hidden">
            <p><span></span></p>
          </div>
        </div>

        <!-- Unnamed (单元格) -->
        <div id="u381" class="ax_default table_cell">
          <img id="u381_img" class="img " src="images/转诊弹窗/u351.png"/>
          <!-- Unnamed () -->
          <div id="u382" class="text">
            <p><span>手机号码</span></p>
          </div>
        </div>

        <!-- Unnamed (单元格) -->
        <div id="u383" class="ax_default table_cell">
          <img id="u383_img" class="img " src="images/转诊弹窗/u353.png"/>
          <!-- Unnamed () -->
          <div id="u384" class="text" style="display:none; visibility: hidden">
            <p><span></span></p>
          </div>
        </div>

        <!-- Unnamed (单元格) -->
        <div id="u385" class="ax_default table_cell">
          <img id="u385_img" class="img " src="images/转诊弹窗/u355.png"/>
          <!-- Unnamed () -->
          <div id="u386" class="text">
            <p><span>17685697456</span></p>
          </div>
        </div>

        <!-- Unnamed (单元格) -->
        <div id="u387" class="ax_default table_cell">
          <img id="u387_img" class="img " src="images/转诊弹窗/u351.png"/>
          <!-- Unnamed () -->
          <div id="u388" class="text">
            <p><span>年龄：</span></p>
          </div>
        </div>

        <!-- Unnamed (单元格) -->
        <div id="u389" class="ax_default table_cell">
          <img id="u389_img" class="img " src="images/转诊弹窗/u353.png"/>
          <!-- Unnamed () -->
          <div id="u390" class="text" style="display:none; visibility: hidden">
            <p><span></span></p>
          </div>
        </div>

        <!-- Unnamed (单元格) -->
        <div id="u391" class="ax_default table_cell">
          <img id="u391_img" class="img " src="images/转诊弹窗/u355.png"/>
          <!-- Unnamed () -->
          <div id="u392" class="text">
            <p><span>70</span></p>
          </div>
        </div>

        <!-- Unnamed (单元格) -->
        <div id="u393" class="ax_default table_cell">
          <img id="u393_img" class="img " src="images/转诊弹窗/u351.png"/>
          <!-- Unnamed () -->
          <div id="u394" class="text">
            <p><span>联系地址：</span></p>
          </div>
        </div>

        <!-- Unnamed (单元格) -->
        <div id="u395" class="ax_default table_cell">
          <img id="u395_img" class="img " src="images/转诊弹窗/u353.png"/>
          <!-- Unnamed () -->
          <div id="u396" class="text" style="display:none; visibility: hidden">
            <p><span></span></p>
          </div>
        </div>

        <!-- Unnamed (单元格) -->
        <div id="u397" class="ax_default table_cell">
          <img id="u397_img" class="img " src="images/转诊弹窗/u355.png"/>
          <!-- Unnamed () -->
          <div id="u398" class="text" style="display:none; visibility: hidden">
            <p><span></span></p>
          </div>
        </div>

        <!-- Unnamed (单元格) -->
        <div id="u399" class="ax_default table_cell">
          <img id="u399_img" class="img " src="images/转诊弹窗/u351.png"/>
          <!-- Unnamed () -->
          <div id="u400" class="text">
            <p><span>转诊类型：</span></p>
          </div>
        </div>

        <!-- Unnamed (单元格) -->
        <div id="u401" class="ax_default table_cell">
          <img id="u401_img" class="img " src="images/转诊弹窗/u353.png"/>
          <!-- Unnamed () -->
          <div id="u402" class="text" style="display:none; visibility: hidden">
            <p><span></span></p>
          </div>
        </div>

        <!-- Unnamed (单元格) -->
        <div id="u403" class="ax_default table_cell">
          <img id="u403_img" class="img " src="images/转诊弹窗/u355.png"/>
          <!-- Unnamed () -->
          <div id="u404" class="text" style="display:none; visibility: hidden">
            <p><span></span></p>
          </div>
        </div>

        <!-- Unnamed (单元格) -->
        <div id="u405" class="ax_default table_cell">
          <img id="u405_img" class="img " src="images/转诊弹窗/u351.png"/>
          <!-- Unnamed () -->
          <div id="u406" class="text">
            <p><span>接诊医院：</span></p>
          </div>
        </div>

        <!-- Unnamed (单元格) -->
        <div id="u407" class="ax_default table_cell">
          <img id="u407_img" class="img " src="images/转诊弹窗/u353.png"/>
          <!-- Unnamed () -->
          <div id="u408" class="text" style="display:none; visibility: hidden">
            <p><span></span></p>
          </div>
        </div>

        <!-- Unnamed (单元格) -->
        <div id="u409" class="ax_default table_cell">
          <img id="u409_img" class="img " src="images/转诊弹窗/u355.png"/>
          <!-- Unnamed () -->
          <div id="u410" class="text" style="display:none; visibility: hidden">
            <p><span></span></p>
          </div>
        </div>

        <!-- Unnamed (单元格) -->
        <div id="u411" class="ax_default table_cell">
          <img id="u411_img" class="img " src="images/转诊弹窗/u411.png"/>
          <!-- Unnamed () -->
          <div id="u412" class="text">
            <p><span>病情描述：</span></p>
          </div>
        </div>

        <!-- Unnamed (单元格) -->
        <div id="u413" class="ax_default table_cell">
          <img id="u413_img" class="img " src="images/转诊弹窗/u413.png"/>
          <!-- Unnamed () -->
          <div id="u414" class="text" style="display:none; visibility: hidden">
            <p><span></span></p>
          </div>
        </div>

        <!-- Unnamed (单元格) -->
        <div id="u415" class="ax_default table_cell">
          <img id="u415_img" class="img " src="images/转诊弹窗/u415.png"/>
          <!-- Unnamed () -->
          <div id="u416" class="text" style="display:none; visibility: hidden">
            <p><span></span></p>
          </div>
        </div>

        <!-- Unnamed (单元格) -->
        <div id="u417" class="ax_default table_cell">
          <img id="u417_img" class="img " src="images/转诊弹窗/u351.png"/>
          <!-- Unnamed () -->
          <div id="u418" class="text">
            <p><span>注意事项：</span></p>
          </div>
        </div>

        <!-- Unnamed (单元格) -->
        <div id="u419" class="ax_default table_cell">
          <img id="u419_img" class="img " src="images/转诊弹窗/u353.png"/>
          <!-- Unnamed () -->
          <div id="u420" class="text" style="display:none; visibility: hidden">
            <p><span></span></p>
          </div>
        </div>

        <!-- Unnamed (单元格) -->
        <div id="u421" class="ax_default table_cell">
          <img id="u421_img" class="img " src="images/转诊弹窗/u355.png"/>
          <!-- Unnamed () -->
          <div id="u422" class="text" style="display:none; visibility: hidden">
            <p><span></span></p>
          </div>
        </div>

        <!-- Unnamed (单元格) -->
        <div id="u423" class="ax_default table_cell">
          <img id="u423_img" class="img " src="images/转诊弹窗/u351.png"/>
          <!-- Unnamed () -->
          <div id="u424" class="text">
            <p><span>转诊原因：</span></p>
          </div>
        </div>

        <!-- Unnamed (单元格) -->
        <div id="u425" class="ax_default table_cell">
          <img id="u425_img" class="img " src="images/转诊弹窗/u353.png"/>
          <!-- Unnamed () -->
          <div id="u426" class="text" style="display:none; visibility: hidden">
            <p><span></span></p>
          </div>
        </div>

        <!-- Unnamed (单元格) -->
        <div id="u427" class="ax_default table_cell">
          <img id="u427_img" class="img " src="images/转诊弹窗/u355.png"/>
          <!-- Unnamed () -->
          <div id="u428" class="text" style="display:none; visibility: hidden">
            <p><span></span></p>
          </div>
        </div>

        <!-- Unnamed (单元格) -->
        <div id="u429" class="ax_default table_cell">
          <img id="u429_img" class="img " src="images/转诊弹窗/u351.png"/>
          <!-- Unnamed () -->
          <div id="u430" class="text">
            <p><span>患者主诉：</span></p>
          </div>
        </div>

        <!-- Unnamed (单元格) -->
        <div id="u431" class="ax_default table_cell">
          <img id="u431_img" class="img " src="images/转诊弹窗/u353.png"/>
          <!-- Unnamed () -->
          <div id="u432" class="text" style="display:none; visibility: hidden">
            <p><span></span></p>
          </div>
        </div>

        <!-- Unnamed (单元格) -->
        <div id="u433" class="ax_default table_cell">
          <img id="u433_img" class="img " src="images/转诊弹窗/u355.png"/>
          <!-- Unnamed () -->
          <div id="u434" class="text">
            <p><span>意识丧失</span></p>
          </div>
        </div>

        <!-- Unnamed (单元格) -->
        <div id="u435" class="ax_default table_cell">
          <img id="u435_img" class="img " src="images/转诊弹窗/u351.png"/>
          <!-- Unnamed () -->
          <div id="u436" class="text">
            <p><span>用药记录：</span></p>
          </div>
        </div>

        <!-- Unnamed (单元格) -->
        <div id="u437" class="ax_default table_cell">
          <img id="u437_img" class="img " src="images/转诊弹窗/u353.png"/>
          <!-- Unnamed () -->
          <div id="u438" class="text" style="display:none; visibility: hidden">
            <p><span></span></p>
          </div>
        </div>

        <!-- Unnamed (单元格) -->
        <div id="u439" class="ax_default table_cell">
          <img id="u439_img" class="img " src="images/转诊弹窗/u355.png"/>
          <!-- Unnamed () -->
          <div id="u440" class="text" style="display:none; visibility: hidden">
            <p><span></span></p>
          </div>
        </div>

        <!-- Unnamed (单元格) -->
        <div id="u441" class="ax_default table_cell">
          <img id="u441_img" class="img " src="images/转诊弹窗/u351.png"/>
          <!-- Unnamed () -->
          <div id="u442" class="text">
            <p><span>出院小结：</span></p>
          </div>
        </div>

        <!-- Unnamed (单元格) -->
        <div id="u443" class="ax_default table_cell">
          <img id="u443_img" class="img " src="images/转诊弹窗/u353.png"/>
          <!-- Unnamed () -->
          <div id="u444" class="text" style="display:none; visibility: hidden">
            <p><span></span></p>
          </div>
        </div>

        <!-- Unnamed (单元格) -->
        <div id="u445" class="ax_default table_cell">
          <img id="u445_img" class="img " src="images/转诊弹窗/u355.png"/>
          <!-- Unnamed () -->
          <div id="u446" class="text" style="display:none; visibility: hidden">
            <p><span></span></p>
          </div>
        </div>

        <!-- Unnamed (单元格) -->
        <div id="u447" class="ax_default table_cell">
          <img id="u447_img" class="img " src="images/转诊弹窗/u411.png"/>
          <!-- Unnamed () -->
          <div id="u448" class="text">
            <p><span>检查情况：</span></p>
          </div>
        </div>

        <!-- Unnamed (单元格) -->
        <div id="u449" class="ax_default table_cell">
          <img id="u449_img" class="img " src="images/转诊弹窗/u413.png"/>
          <!-- Unnamed () -->
          <div id="u450" class="text" style="display:none; visibility: hidden">
            <p><span></span></p>
          </div>
        </div>

        <!-- Unnamed (单元格) -->
        <div id="u451" class="ax_default table_cell">
          <img id="u451_img" class="img " src="images/转诊弹窗/u415.png"/>
          <!-- Unnamed () -->
          <div id="u452" class="text">
            <p><span>意识模糊,体温:38℃(低热),呼吸频率:20次/分,呼吸节律:正常,心率:40次/分,心律:整齐,血压:140/90mmHg,三凹征、吸气、喘鸣,胸、腹矛盾呼吸,四肢软瘫,四肢软瘫</span></p>
          </div>
        </div>

        <!-- Unnamed (单元格) -->
        <div id="u453" class="ax_default table_cell">
          <img id="u453_img" class="img " src="images/转诊弹窗/u351.png"/>
          <!-- Unnamed () -->
          <div id="u454" class="text">
            <p><span>心电检查结果：</span></p>
          </div>
        </div>

        <!-- Unnamed (单元格) -->
        <div id="u455" class="ax_default table_cell">
          <img id="u455_img" class="img " src="images/转诊弹窗/u353.png"/>
          <!-- Unnamed () -->
          <div id="u456" class="text" style="display:none; visibility: hidden">
            <p><span></span></p>
          </div>
        </div>

        <!-- Unnamed (单元格) -->
        <div id="u457" class="ax_default table_cell">
          <img id="u457_img" class="img " src="images/转诊弹窗/u355.png"/>
          <!-- Unnamed () -->
          <div id="u458" class="text" style="display:none; visibility: hidden">
            <p><span></span></p>
          </div>
        </div>

        <!-- Unnamed (单元格) -->
        <div id="u459" class="ax_default table_cell">
          <img id="u459_img" class="img " src="images/转诊弹窗/u351.png"/>
          <!-- Unnamed () -->
          <div id="u460" class="text">
            <p><span>初步诊断：</span></p>
          </div>
        </div>

        <!-- Unnamed (单元格) -->
        <div id="u461" class="ax_default table_cell">
          <img id="u461_img" class="img " src="images/转诊弹窗/u353.png"/>
          <!-- Unnamed () -->
          <div id="u462" class="text" style="display:none; visibility: hidden">
            <p><span></span></p>
          </div>
        </div>

        <!-- Unnamed (单元格) -->
        <div id="u463" class="ax_default table_cell">
          <img id="u463_img" class="img " src="images/转诊弹窗/u355.png"/>
          <!-- Unnamed () -->
          <div id="u464" class="text">
            <p><span>心脏骤停</span></p>
          </div>
        </div>

        <!-- Unnamed (单元格) -->
        <div id="u465" class="ax_default table_cell">
          <img id="u465_img" class="img " src="images/转诊弹窗/u351.png"/>
          <!-- Unnamed () -->
          <div id="u466" class="text">
            <p><span>家族史：</span></p>
          </div>
        </div>

        <!-- Unnamed (单元格) -->
        <div id="u467" class="ax_default table_cell">
          <img id="u467_img" class="img " src="images/转诊弹窗/u353.png"/>
          <!-- Unnamed () -->
          <div id="u468" class="text" style="display:none; visibility: hidden">
            <p><span></span></p>
          </div>
        </div>

        <!-- Unnamed (单元格) -->
        <div id="u469" class="ax_default table_cell">
          <img id="u469_img" class="img " src="images/转诊弹窗/u355.png"/>
          <!-- Unnamed () -->
          <div id="u470" class="text" style="display:none; visibility: hidden">
            <p><span></span></p>
          </div>
        </div>

        <!-- Unnamed (单元格) -->
        <div id="u471" class="ax_default table_cell">
          <img id="u471_img" class="img " src="images/转诊弹窗/u351.png"/>
          <!-- Unnamed () -->
          <div id="u472" class="text">
            <p><span>疾病史：</span></p>
          </div>
        </div>

        <!-- Unnamed (单元格) -->
        <div id="u473" class="ax_default table_cell">
          <img id="u473_img" class="img " src="images/转诊弹窗/u353.png"/>
          <!-- Unnamed () -->
          <div id="u474" class="text" style="display:none; visibility: hidden">
            <p><span></span></p>
          </div>
        </div>

        <!-- Unnamed (单元格) -->
        <div id="u475" class="ax_default table_cell">
          <img id="u475_img" class="img " src="images/转诊弹窗/u355.png"/>
          <!-- Unnamed () -->
          <div id="u476" class="text" style="display:none; visibility: hidden">
            <p><span></span></p>
          </div>
        </div>

        <!-- Unnamed (单元格) -->
        <div id="u477" class="ax_default table_cell">
          <img id="u477_img" class="img " src="images/转诊弹窗/u351.png"/>
          <!-- Unnamed () -->
          <div id="u478" class="text">
            <p><span>过敏史：</span></p>
          </div>
        </div>

        <!-- Unnamed (单元格) -->
        <div id="u479" class="ax_default table_cell">
          <img id="u479_img" class="img " src="images/转诊弹窗/u353.png"/>
          <!-- Unnamed () -->
          <div id="u480" class="text" style="display:none; visibility: hidden">
            <p><span></span></p>
          </div>
        </div>

        <!-- Unnamed (单元格) -->
        <div id="u481" class="ax_default table_cell">
          <img id="u481_img" class="img " src="images/转诊弹窗/u355.png"/>
          <!-- Unnamed () -->
          <div id="u482" class="text" style="display:none; visibility: hidden">
            <p><span></span></p>
          </div>
        </div>
      </div>

      <!-- Unnamed (下拉列表框) -->
      <div id="u483" class="ax_default droplist">
        <select id="u483_input">
          <option value="请选择">请选择</option>
          <option value="医院A（推荐）">医院A（推荐）</option>
          <option value="医院B">医院B</option>
        </select>
      </div>

      <!-- Unnamed (矩形) -->
      <div id="u484" class="ax_default primary_button">
        <div id="u484_div" class=""></div>
        <!-- Unnamed () -->
        <div id="u485" class="text">
          <p><span>上转</span></p>
        </div>
      </div>

      <!-- Unnamed (文本框) -->
      <div id="u486" class="ax_default text_field">
        <input id="u486_input" type="text" value=""/>
      </div>

      <!-- Unnamed (组合) -->
      <div id="u487" class="ax_default" data-left="147" data-top="179" data-width="148" data-height="56">

        <!-- Unnamed (组合) -->
        <div id="u488" class="ax_default" data-left="147" data-top="179" data-width="148" data-height="56">

          <!-- Unnamed (矩形) -->
          <div id="u489" class="ax_default">
            <div id="u489_div" class=""></div>
            <!-- Unnamed () -->
            <div id="u490" class="text">
              <p><span>1934-11-22</span></p>
            </div>
          </div>

          <!-- Unnamed (图片) -->
          <div id="u491" class="ax_default">
            <img id="u491_img" class="img " src="images/转诊弹窗/u491.png"/>
            <!-- Unnamed () -->
            <div id="u492" class="text" style="display:none; visibility: hidden">
              <p><span></span></p>
            </div>
          </div>

          <!-- Unnamed (动态面板) -->
          <div id="u493" class="ax_default">
            <div id="u493_state0" class="panel_state" data-label="状态1" style="">
              <div id="u493_state0_content" class="panel_state_content">
              </div>
            </div>
          </div>
        </div>
      </div>

      <!-- Unnamed (下拉列表框) -->
      <div id="u494" class="ax_default droplist">
        <select id="u494_input">
          <option value="请选择">请选择</option>
          <option value="普通">普通</option>
          <option value="急诊">急诊</option>
        </select>
      </div>

      <!-- Unnamed (文本框) -->
      <div id="u495" class="ax_default text_field">
        <input id="u495_input" type="text" value=""/>
      </div>

      <!-- Unnamed (文本框) -->
      <div id="u496" class="ax_default text_field">
        <input id="u496_input" type="text" value=""/>
      </div>

      <!-- Unnamed (文本框) -->
      <div id="u497" class="ax_default text_field">
        <input id="u497_input" type="text" value=""/>
      </div>

      <!-- Unnamed (文本框) -->
      <div id="u498" class="ax_default text_field">
        <input id="u498_input" type="text" value=""/>
      </div>

      <!-- Unnamed (文本框) -->
      <div id="u499" class="ax_default text_field">
        <input id="u499_input" type="text" value=""/>
      </div>

      <!-- Unnamed (文本框) -->
      <div id="u500" class="ax_default text_field">
        <input id="u500_input" type="text" value=""/>
      </div>

      <!-- Unnamed (文本框) -->
      <div id="u501" class="ax_default text_field">
        <input id="u501_input" type="text" value=""/>
      </div>

      <!-- Unnamed (文本框) -->
      <div id="u502" class="ax_default text_field">
        <input id="u502_input" type="text" value=""/>
      </div>

      <!-- Unnamed (文本框) -->
      <div id="u503" class="ax_default text_field">
        <input id="u503_input" type="text" value=""/>
      </div>
    </div>
  </body>
</html>
